Plica injury - any specific excercises to eliminate or is it physical removal only?

[strauss_jon]

Hi there - I was wondering if someone could give me a little advice on a plica injury which occurred after a biking accident.

This link is uncanny in the symptons - exactly as described here:
KNEEissues and Clinical Casebook : Dr. Angus Strover : Plica of the knee – the great mimic :

I had physio on my right knee for 2 yrs to no avail. MRI and x-ray showed nothing. 1st arthroscopy appointment i copped out of because i was so scared! Year later I was convinced to have one because apparently that would be the only solution. So I took the brave step and had it done.

It's actually made things a lot worse. 6 months later, I have numbness in my knee (not so important), knee very tender but worse of all the plica seems to be much worse - tighter and i feel it a lot more plus it clicks earlier in the knee bend.

Before I go through with another (last resort) arthroscopy, I was wondering if there's any excercises/stretches/something else I could do for myself to eliminate the plica...or can it only be cured by physical removal of the plica via an arthroscopy? Some stretches/ice etc relieves the pain temporarily but obviously it would be nice to get rid of it. I really don't want to go through another arthroscopy if I can help it - especially after the last treatment which for me was a disaster. Most excercises I do just aggravate the pain.

Any advice would be greatfully received. Thanks in advance, Jon

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[jerryhesch]

Hi,
You and I have parallell signs and symptoms! Did you get a video of your surgery? I did, I truly believe that maore of the plication could have been removed. I also believe that I may have an extra-capsular mass, which I can palpate about 8-10cm above the medial joint line. I will pursue work up soon, ultrasound was non-revealing. I wonder if I had a bleed into the medial muscle/tendon.
anyway, please let me know if you have a film copy of your scope. I will follow your replies and other advice. If I o for a scope, I hope we can also expose the medial soft tissues extracapsularly.
My Ortho surgeon was most reluctant to accept my self diagnosis-much less listen (yes I could have gone to another but had many many other overarching issues at the time) and it took 9 months, scope was helpful but in time sx have enhanced.
best of luck
jerry hesch

[neurospast]

numbness and more pain hmmm sounds like some nerve damage or at least nerve involvement. Exercises seem to aggravate, in general exercises will aggravate (temporarily!) and for shure if scar tissue is a major item. I think you should get in touch with a physiotherapist to get assessed (and if you are a physio get a colleague have a look at it). The webside you show tells things from an orthoped's view, pain on the medial side of the knee can e.g. also be referred pain from the hip or back. Which by the way doesn't exclude knee problems. The problem is in general that there are many causes for pain in a certain area and the internet can be very enlightening but also very unfocussing.

[strauss_jon]

Hey Jerry, thanks for replying. Sorry I don't have a video of my surgery. I just left it to the 'expert' to sort it out - end. X-Rays, MRI etc showed nothing. I only went through with the proc because people told me it would be fine, minor procedure, happens all the time, high success rate, bla bla etc. How i have regretted it! The health service in the uk isn't very good - you have to wait ages for a physio
appointment, hence my question if i can do anything myself to help the plica .
Anyway - let me know if you have any luck with your knee . I hope you get better. It's not pleasant, i know...

Neurospast - thanks also for your post. Apparently there's a big nerve on the out'r part of the knee (near where there's a bit of bone that sticks out) - apparently damage to this is common on arthroscopies and recovers ok. I'm not so bothered about the nerve damage. It doesnt affect me, it just feels a bit weird when i touch it. Interesting to note about the symptoms sourcing from the back or the hip. Mine's definately the knee, I won't forget the accident, fell off my bike and whacked my knee directly on the concrete - ouch! Plus the surgeon said he found the plica, but he probably just didn't do a thorough enough job removing the whole lot. Knee strength/muscle mass is all there, problem is with the bend
> 45 degrees (scar tissue - tight and then painful click) plus there's a load of stuff floating around the knee. Unpleasant.

From the evidence I have found, plica's can only be removed physically. No amount of stretching, excercises will remove it. Makes sense. Would appreciate you letting me know if there's any evidence on the contrary - but i won't be holding my breath!

Thanks again - Jon